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[Federal Register Volume 63, Number 132 (Friday, July 10, 1998)]
[Notices]
[Pages 37387-37394]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 98-18437]

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Administration for Children and Families
[Notice of Program Announcement No. ACF/ACY/CB-98-05]

New Child Welfare Demonstration Project Proposals Submitted by 
States for Waivers Pursuant to Section 1130 of the Social Security Act 
(the Act); Titles IV-E and IV-B of the Act; Public Law 103-432

AGENCY: Administration for Children and Families, HHS.

ACTION: Notice.

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SUMMARY: This notice lists new proposals for child welfare waiver 
demonstration projects submitted to the Department of Health and Human 
Services pursuant to the guidance contained in Information Memorandum 
ACYF-CB-IM-98-01 dated February 13, 1998, public notice of which was 
given in the Federal Register of March 4, 1998, Vol. 63, No. 42, page 
10637.

COMMENTS: We will accept written comments on these proposals, but will 
not provide written responses to comments. We will neither approve nor 
disapprove any new proposal for at least 30 days after the date of this 
notice to allow time to receive and consider comments. Direct comments 
as indicated below.

ADDRESSES: For specific information or questions on the content of a 
project or requests for copies of a proposal, contact the State contact 
person listed for that project.

    Comments on a proposal should be addressed to: Michael W. Ambrose, 
Administration on Children, Youth and Families, Children's Bureau, 330 
C Street, SW, Mary E. Switzer Building, Room 2058, Washington, D.C., 
20201. FAX: (202) 260-9345.

SUPPLEMENTARY INFORMATION:

I. Background

    Under Section 1130 of the Social Security Act (the Act), the 
Secretary of Health and Human Services (HHS) may approve child welfare 
waiver demonstration project proposals with a broad range of policy 
objectives.
    In exercising her discretionary authority, the Secretary has 
developed a number of policies and procedures for reviewing proposals. 
The most recent expression of these policies and procedures may be 
found in the February 13, 1998 Information Memorandum cited above, a 
copy of which may be found at the ACF website at http://www.acf.dhhs.gov/program/cb/demonstrations or may be obtained from the 
National Clearinghouse on Child Abuse and Neglect Information, (800) 
394-3366, internet address [email protected]>. We are committed to a 
thorough and expeditious review of state proposals to conduct child 
welfare demonstrations.

II. Listing of New Proposals

    As part of our procedures, we are publishing a notice in the 
Federal Register of all new proposals. This notice contains summaries 
of 17 proposals received by April 30, 1998. Each of the proposals 
contains an assurance that the proposed demonstration effort will be 
cost neutral to the federal government over the life of the proposed 
effort; and each proposal contains an evaluation component designed to 
assess the effectiveness of the project.

State: Arkansas

    Description: The State of Arkansas proposes to use title IV-E funds 
to enhance mental health services available for children in foster care 
and children at risk of being placed in foster care, and thereby reduce 
barriers to permanency for those children. The State intends, in 
October, 1998, to implement a system for mental health managed care for 
all title XIX eligible children, and all children in DCFS foster care. 
Under this demonstration, the State would use title IV-E funds to

[[Page 37388]]

provide supplemental payment to the managed care capitated rate to (1) 
allow for previously unallowable services to title IV-E eligible 
children (Managed Care component); (2) provide specialized, 
collaborative case management services to a group of randomly selected 
foster children (some of whom may not be IV-E eligible) and children 
who are at risk for being placed in foster care because of their 
service needs, to identify and address barriers to permanency (FOCUS 
component); and (3) provide training to child welfare staff as well as 
others in the community to enhance participation in the project from 
agencies and persons outside DCFS.
    Arkansas proposes to conduct a process evaluation as well as an 
evaluation to produce outcome data, and a cost/benefit analysis. The 
evaluation design for the collaborative case management services 
portion of the project is proposed as a design based on random 
assignment of children or families to treatment or control conditions.
    The State requests waivers of title IV-E to allow the State to 
conduct a portion of the Demonstration on less than a Statewide basis, 
to allow the State to expend title IV-E funds for children and families 
who are not normally eligible, to allow the State to make payments for 
services that are not normally covered under Part E of title IV of the 
Act, and to allow the State to expend title IV-E funds for training of 
persons who are not normally eligible. The State also has requested a 
title XIX waiver under the authority of section 1915(b) of the Social 
Security Act to establish a mental health managed care system to reduce 
costs, prevent unnecessary and inappropriate utilization, and ensure 
access to quality mental health care for Medicaid recipients.
    Contact Person: Lee Frazier, Director, Arkansas Department of Human 
Services, 329 Donaghey Plaza South, P.O. Box 1437, Little Rock, 
Arkansas 72203-1437, Phone: (501) 682-8650, Fax: (501) 682-6836.

State: Connecticut

    Description: Connecticut's proposal has two distinct program 
components. The first proposes to use title IV-E funds to implement a 
subsidized guardianship program and to change case work practice to 
provide increased emphasis and support for guardianship as a viable 
permanency option for cases where reunification or adoption of children 
living with relative care givers is neither appropriate nor feasible. 
The second component proposes to conduct pilot demonstrations of a 
service delivery model in which a single lead agency would organize, 
manage and provide an array of services to address the specific needs 
of children who require placement in residential or group homes.
    The goal of the proposed guardianship program is to provide another 
means of attaining permanency for children who would otherwise remain 
in foster care. The program would be implemented state-wide and would 
focus on children residing with relative caregivers. It would provide: 
(1) A monthly subsidy on behalf of the child payable to the guardian 
equal to the prevailing appropriate foster care rate; (2) a medical 
subsidy comparable to the medical subsidy for subsidized adoption (if 
the child has no private health insurance); and (3) a lump sum payment 
for one-time expenses resulting from the assumption of care for the 
child (when other resources are unavailable). Waivers would be required 
to allow for Federal IV-E reimbursement for payments to relative 
caregivers when a child leaves legal custody of the State agency, and 
for program administration and services that are not currently 
allowable under IV-E.
    The proposed ``single contact/continuum of care'' program's goal is 
to test the effectiveness of the service delivery model in which the 
State's Child and Family agency (DCF) would contract with a single Lead 
Service Agency that would manage subcontracts and create an expanded 
network of regular and specialized services for children and youth with 
behavioral problems who are referred to residential or group homes.
    The State hypothesizes that this demonstration project would 
decrease the length of stay in restrictive settings; increase treatment 
options for children and families; improve permanency outcomes for 
children and provide long-term stability in the community; and 
establish a more flexible, incentive-oriented fiscal environment for 
service providers. One or two pilot programs would be established to 
serve 30 children per pilot over a five year project period. The 
program would be targeted to DCF children aged 7 to 15. A 15 month 
service period, which includes a minimum of 3 months of aftercare, is 
projected for each child. Waivers are requested to allow the 
administrative and services costs to be IV-E reimbursable.
    Contact Person: Robert Dakers, Department of Children and Families, 
505 Hudson Street, Hartford, CT 06106-7107, Phone: (860) 550-6542, Fax: 
(860) 566-7947.

State: District of Columbia

    Description: The District of Columbia proposes to test the ability 
of a partnership between the Child and Family Services Agency (CFSA) 
and neighborhood-based community collaboratives to improve service 
delivery for children in kinship placements. Teams of CFSA social 
workers matched with trained collaborative community workers would 
provide family preservation services to the kinship triad: the kinship 
caregiver, the parent and the child. CFSA hypothesizes that this 
public-private partnership would increase the number of children who 
achieve permanency, speed the permanency process, increase stability in 
kinship care families, increase outreach and education that promotes 
child safety and reduce the incidence of further abuse or neglect for 
children and families receiving these services, and reduce time in out-
of-home placements and the number of new foster care placements.
    To test its hypotheses, CFSA has requested waivers to permit title 
VI-E funds to be expended for services and individuals that are not 
eligible under existing law. The requested waiver would allow the 
District to be reimbursed for foster care services provided to children 
who are not IV-E eligible, including those who are living with kinship 
caregivers, and to allow adoption subsidy payments for children who are 
not IV-E eligible.
    The District's proposed evaluation design would randomly assign 
eligible kinship triads to experimental and control groups. The 
experimental group would receive the team approach and the control 
group would receive traditional services from a social worker. The 
evaluation would measure: Changes in Child Safety through the number of 
new allegations, allegations after a case is closed, disruptions in 
placement, entries or re-entries into non-kinship foster care; Child 
Well-Being through the Child and Adolescent Functional Assessment 
Scale; and Child Permanency as indicated by adoption, legal custody or 
re-unification.
    Contact Person: Ernestine Jones, General Receiver, Office of the 
General Receiver, Child and Family Services Agency, 900 Second Street, 
N.E., Suite 221, Washington, DC 20002, Phone: (202) 842-0888, Fax: 
(202) 842-2335.

State: Florida

    Description: Florida proposes to demonstrate whether children and 
families can achieve better outcomes through: privatization, managed 
care, and Medicaid therapeutic service

[[Page 37389]]

integration. In response to a 1996 legislative mandate to private child 
welfare services, the Florida Department of Children and Families 
allowed community-based providers to operate five pilot projects. 
Waivers under a demonstration project would enable these providers to 
use State funds and federal title IV-E funds to purchase therapeutic 
services for children who do not meet Medicaid ``medical necessity'' 
restrictions for therapeutic services. In addition, at least one 
demonstration site would receive a capitation payment linked to the 
number of children living in poverty. Each site would then utilize this 
funding flexibility to reconfigure services. The state hypothesizes 
that this would expedite all aspects of permanency, improve family 
capacity to care for children, increase family involvement and the 
range of supports available to families, and increase youths' 
preparation for independence.
    Florida proposes to compare the performance of selected comparison 
counties to the performance of the demonstration counties. The State's 
evaluation design would include outcome evaluation, process evaluation, 
cost analysis and cost benefit analysis. Outcome measures include 
safety and protection, permanency goals, stability and functioning and 
customer satisfaction. Process measures would examine policies, 
procedures, client flow, staffing expertise and levels, service types, 
duration, mix, timing and accessibility, assessment processes, and 
court, community and media relationships. A cost analysis would study 
all costs associated with the project and comparison counties. The 
cost-benefit analysis merges cost data with outcome data to determine 
the overall value of the outcomes.
    Contact Person: Margaret Taylor, Florida Department of Children and 
Families, 1317 Winewood Boulevard, Tallahassee, Florida 32399-0700, 
Phone: (850) 922-0149, Email: Taylor __M[email protected].

State: Iowa

    Description: Iowa proposes to fund community-based services to 
improve outcomes for children and families in the child welfare system 
using title IV-E funds. The State plans to build on the existing 
Decategorization Project areas and Innovation Zones to increase the 
capacity of local organizations to care for children and families and 
build service strategies for children and families in the child welfare 
system. The State believes this demonstration would efficiently reduce 
the amount of time children spend in out-of-home care and move children 
into permanent placements more quickly.
    The State proposes to implement this demonstration in several 
counties or clusters and use a comparison group of counties to evaluate 
both the impact and the cost of using title IV-E funds flexibly. Under 
the State's plan, counties would present proposals for participating in 
the IV-E demonstration that focus on: (1) Diverting children from out-
of-home care, including foster care, group care, residential care, and 
mental health or juvenile justice institutions; (2) providing for 
permanency for children quickly and effectively; and/or (3) reducing 
re-entry into out-of-home care. For each county's or cluster's 
proposal, the State is proposing that the eligibility determination for 
title IV-E be eliminated under the demonstration. To assess the 
demonstration project, the State proposes to compare demonstration 
counties or clusters to children in comparison counties or clusters. 
The evaluation would produce process, outcome, and cost/benefit 
information.
    The State is requesting waivers of certain provisions of title IV-E 
which would allow Iowa to: (1) Use title IV-E funds to pay for 
additional services for children and families; and (2) spend title IV-E 
funds on children and families who would not normally be eligible for 
title IV-E.
    Contact Person: Mary Nelson, Division Administrator for Adult, 
Children and Family Services, Iowa Department of Human Services, Hoover 
State Office Building, Des Moines, IA 50319-0114, Phone: (515) 281-
5521, Fax: (515) 281-4597.

State: Kansas

    Description: Kansas proposes to fund a demonstration project 
intended to ``support and enhance'' the new performance-based 
administration of the Kansas Child Welfare System. The Kansas 
Department of Social and Rehabilitation Services (SRS) intends to 
conduct a multi-faceted project consisting of a subsidized guardianship 
program, integrated child welfare training, enhanced drug/alcohol 
services, and subsidized family reintegration upon return home 
(aftercare). In addition, the initiative would compare the new case 
rate, performance-based payment system (already in place statewide) 
with the traditional fee-for-service payment system in order to 
determine which payment method produces better outcomes.
    The State hypothesizes that: (1) The subsidized guardianship 
project would facilitate the permanency of children when adoption and 
reunification with their family is not feasible; (2) an integrated 
child welfare training project for private and public social service 
professionals aimed at supporting an integrated social service model 
with a ``single worker per family'' concept would provide social 
service staff with the tools needed to meet the needs of families, 
including preventing out-of-home placement; (3) a strengthened approach 
to drug and alcohol dependency assessment and treatment planning 
directed to IV-E eligible children and families would decrease the 
number of disruptions to placement and decrease the length of stay in 
out-of-home placement; and (4) a project making resources and services 
such as respite care, family support services, parenting education, 
family, individual, and group therapy, available to families upon 
reintegration of a child would prevent further disruption.
    The proposed evaluation design would compare the fee-for-service 
delivery system to the case rate performance based delivery system. 
Since the SRS has already shifted all of the adoption and foster care 
delivery systems into the latter, it would be necessary to randomly 
select children to be placed ``outside the case rate.'' The random 
selection process would be applied to selected area offices which 
collectively represent 40% of the children served, and three of the 
five foster care regions. The State would measure outcomes such as 
amount of time for children to be placed with adoptive families, 
percentage of finalized adoptions within 12 months, disrupted 
placements, number of siblings placed together, number of placement 
changes, new substantiated claims of abuse or neglect, percentage of 
children placed within Regional boundaries, percentage of children 
returned to family or achieving permanence, re-entry into foster care, 
percentage of children achieving permanency and family satisfaction 
with services.
    The proposed project would be cost neutral and would run for five 
years.
    Contact Person: Teresa Markowitz, Commissioner, Kansas Department 
of Social and Rehabilitation Services, 915 SW Harrison Street, Topeka, 
Kansas 66612, Phone: (785) 368-6448, Fax: (785) 368-8159, Email: 
tamasrcfs.wpo.state.ks.us.

State: Maine

    Description: Maine proposes a two-phase demonstration project. The 
first phase would involve the design and implementation of an adoption 
training

[[Page 37390]]

curriculum for mental health professionals and other service providers 
who would become expert in working with families in need of post-
adoption services. The second aspect of the demonstration would phase 
in the purchase and delivery of post-adoption support services for 
families who adopt special needs children. The overall goals of the 
project are to increase the number of special needs children who are 
adopted and to decrease the number of disrupted adoptions. It is the 
State's hypothesis that increasing the array of supportive services 
available to families who elect adoption would promote family stability 
and reduce disruptions, as well as encourage other community members to 
consider adopting children with special needs. The State has proposed a 
five-year demonstration period.
    The demonstration would be conducted in four test sites, two urban 
and two rural, from among the Department of Human Services district 
offices. At present, Maine has about 535 IV-E eligible children free 
for adoption.
    The evaluation design calls for establishing a control and 
experimental group in each pair of selected sites, i.e., one urban 
control, one urban experimental, one rural control and one rural 
experimental. The State expects that a total of 200 children and 
families (100 control and 100 experimental) would participate in the 
study over the life of the demonstration. The experimental group would 
receive the expanded post-adoption services, while the control group 
would receive the current service mix.
    Outcome measures would include the number of special needs 
adoptions, the incidence of disrupted adoptions, the average length of 
stay in foster care and the stability of the adoptive families.
    Waivers are requested to enable the State to use title IV-E funds 
to provide services which are not normally allowed under title IV-E 
Adoption Assistance or title IV-E Foster Care.
    Contact Person: Dawn Stiles, Department of Human Services, State 
House Station #11, Augusta, Maine 04333, Phone: (207) 287-5060, Fax: 
(207) 287-5282, TDD: (207) 287-4479.

State: Mississippi

    Description: Mississippi proposes to expand the use of title IV-E 
funds to non-IV-E eligible children and families and to use title IV-E 
funds for any items or activities that would eliminate or reduce harm 
to children and families. The demonstration proposes to implement a 
Child-Focused Family Centered Practice Methodology, which emphasizes 
the safety and best interests of children through the elimination of 
harm-causing factors. The proposed project involves using title IV-E 
funds to provide services for children and families whether children 
are in State custody or not, including children in residential care. 
This project would involve the identification of services, the 
development of a service delivery system, the development of a business 
plan, the building of multi-disciplinary case management teams, and 
ongoing evaluation and program modification. It is the State's 
hypothesis for the demonstration that the expenditure of funds to 
benefit any child, regardless of IV-E eligibility, to reduce or 
eliminate factors that cause harm to that child, would demonstrate a 
reduction in harm to children. The demonstration would result in safer 
children due to the reduction of harm to children who are a part of the 
demonstration. The State has proposed a five year demonstration period. 
The demonstration would be conducted in eight selected counties, which 
are located in two Division of Family and Children's Services' (DFCS) 
regions.
    The State proposes an evaluation design in which eligible children 
and families would be randomly assigned to experimental and control 
groups. The experimental group would receive a combination of existing 
or modified services along with newly created services. The control 
group would be served by the existing services only. The evaluation 
would compare results from the experimental group and control group. 
Outcome measures include: decrease in the proportion of children who 
experience subsequent abuse or neglect; increase in the proportion of 
children who remain permanently with their parental family; among those 
children placed outside of their parental home, increase in the 
proportion who are in placements in the community of their parental 
family and who are placed with relatives; decrease in the proportion of 
children placed in foster care; decrease in the average number of 
placements for children in foster care; decrease in the amount of time 
spent in foster care; an increase among children awaiting adoption in 
the proportion of children adopted and the speed of the process; where 
two or more siblings are placed outside of their parental home, 
increase in the proportion of sibling groups where siblings are placed 
in the same setting; and increase in the well-being of children.
    Waivers are requested to allow the State to use title IV-E funds 
for children and families who are not normally eligible under title IV-
E and to use title IV-E funds, including funds which would be 
reimbursed as costs of administration, for the provision of services.
    Contact Person: Henry Goodman, Department of Human Services, 750 
North State Street, Jackson, Mississippi 39202, Phone: (601) 873-6144, 
Fax: (601) 359-4477.

State: Montana

    Description: Montana's Department of Public Health and Human 
Services (DPHHS) is requesting approval of a Child Welfare 
Demonstration Project, which would allow title IV-E funds to be used 
for a subsidized guardianship program. The demonstration would 
authorize a subsidized guardianship program for eligible children; 
provide a monthly guardianship subsidy, Medicaid and non-recurring 
costs associated with establishing legal guardianship, and provide 
federal financial participation in the costs of administration and 
training associated with the guardianship program.
    Montana postulates that guardianship provides the child and family 
a legally recognized relationship, increases the sense of family by 
granting the caretakers in the family the right and responsibility to 
make important decisions regarding a child in their home, provides a 
more stable placement than does long term foster care and is less 
costly, due in part to a reduction in the administrative costs 
associated with foster care. The demonstration project would be 
statewide, for five years, and would include children on the state's 
seven reservations. The project would serve children 12 years old or 
older and would mirror the adoption assistance program as much as 
possible. The project is expected to be cost neutral. Comparison of the 
costs associated with the demonstration group and the control group 
will be used to determine the fiscal effect of the demonstration.
    The Montana DPHHS is also considering joining a consortium of 
states in Region VIII, which would seek to demonstrate the impact of 
allowing IV-E funds to be provided as a direct pass through of federal 
funds to one or more tribes in Montana and in each of the other 
consortium States.
    The State requests waivers to allow title IV-E funds to be used for 
children who are not IV-E eligible and for services which are not 
ordinarily reimbursable under title IV-E. The DPHHS intends to use 
random assignment of children to either a service or a control group, 
and will use an independent contractor to conduct the required 
evaluation.
    Contact Person: Hank Hudson, Administrator, Child and Family

[[Page 37391]]

Services Division, Department of Public Health and Human Services, 
State of Montana, P.O. Box 8005, Helena, Montana 59604-8005, Phone: 
(406) 444-5900, Fax: (406) 444-2547.

State: Nebraska

    Description: The Nebraska Health and Human Services System proposes 
to test local approaches to child welfare system change through a 
demonstration project. It is the State's hypothesis that the 
combination of flexible use of title IV-E funds and local integrated 
networks would: (1) Promote positive social and health outcomes and 
prevent negative outcomes for children and families; (2) improve the 
well-being of children who are at risk of, or actually require out-of-
home placement; and (3) improve the family functioning and 
participation of child welfare involved families. The project would 
involve entities across the State, including three which have existing 
relationships with the State system, by forming local integrated 
networks to facilitate a better use of resources. The State would 
provide technical assistance, support and expectations for systems 
management. The effort is part of an ongoing Network Development 
Strategy that is being implemented Statewide.
    The state estimates that a total of 3,240 children would be served 
through the demonstration project. Each site would utilize the flexible 
funds differently, so the outcome measures for each would be different. 
Sites are expected to use the waiver authority for purposes which 
include: promoting the wraparound process for each child and adolescent 
at high risk of out-of-home placement; focusing on community-based 
prevention, intensive community-based services, community re-
integration of out-of-area high-needs children, and child and community 
safety and community ownership by developing a Managed Care Child 
Welfare system in the third year of the project; sustaining and 
enhancing the local service network, increasing parental, family and 
civic involvement, co-locating staff and integrated services, expanding 
choice and opportunities, and increasing communication and networking.
    Nebraska is requesting waivers of title IV-E to permit 
reimbursement for expenditures made on behalf of children who are not 
IV-E eligible, and for purposes that do not ordinarily qualify for 
reimbursement under IV-E.
    The State proposes to compare the demonstration sites with 
geographical areas that do not have flexible use of funds. The State 
would examine child safety, permanence, child and family well-being and 
community safety and responsibility outcomes.
    Contact Person: John Mader, Program Specialist, Protection and 
Safety Division, Nebraska Health and Human Services System, 2345 North 
60th Street, Lincoln, NE 68507, Phone: (402) 471-9364, Fax: (402) 471-
9034, Email:[email protected].

State: New Hampshire

    Description: New Hampshire proposes to use title IV-E funds to hire 
a substance abuse specialist with expertise regarding child protective 
services who would conduct substance abuse assessments of parents where 
alcohol or other drug abuse is believed to be a factor contributing to 
the child's abuse or neglect. For those families in need of ongoing 
services, this staff person would also assist them in accessing 
intensive, community based substance abuse treatment services. It is 
the State's hypothesis that the provision of these immediate, targeted 
and intensive services would enable families better to provide a safe, 
nurturing environment for their children, resulting in the prevention 
of placement or a reduction in the length of time children remain in 
out-of-home care. The State has proposed a five year demonstration 
period.
    The demonstration would be conducted in two District Offices of the 
State's child welfare agency: those located in Manchester and Nashua. 
December 1997 statistics showed 245 children in foster care in these 
districts who were IV-E eligible. Of these, 56% had caretakers in which 
substance abuse was a factor in their maltreatment.
    The State proposes an evaluation design in which eligible families 
would be randomly assigned to experimental and control groups. The 
experimental group would receive the services of the substance abuse 
specialist while the control group would receive the current services 
mix. Outcomes for each group would be tracked. The State would examine 
outcomes including placement prevention, more timely reunification, 
more timely alternate permanency planning for children unable to return 
home, and cost savings as a result of improved permanency planning. The 
State expects approximately 120 children in the experimental condition 
and 120 in the control condition.
    Waivers are requested in order to (a) serve children not otherwise 
eligible for IV-E (children at risk of but not in foster care); and (b) 
provide services not normally covered by IV-E (substance abuse 
assessment, referral and case management services).
    Contact Person: Nancy Rollins, Division for Children, Youth and 
Families, New Hampshire Department of Health and Human Services, 6 
Hazen Drive, Concord, NH 03301-6522, Phone: (603) 271-4451, Fax: (603) 
271-4729, Email: [email protected].

State: New Jersey

    Description: New Jersey seeks to implement concurrent permanency 
planning and the use of the fost-adopt model of foster care. In New 
Jersey, the average length of stay for children who are six years old 
or less with a goal of adoption is 25 months in their current 
placement. The State proposes to use title IV-E funding for services 
and activities designed to reduce to 15 months, the time in foster care 
preceding the initiation of termination of parental rights/initiation 
of permanency, for children whose permanency goal is adoption as 
envisioned by the Adoption and Safe Families Act. The state would hire 
case managers specifically dedicated to the project to apply the 
permanency reform/fost-adopt model for both title IV-E eligible and 
non-eligible children. Funds would also be used for enhanced legal 
services and substance abuse services.
    The proposed demonstration builds upon and further elaborates the 
permanency reform project underway in Union, Middlesex and Essex 
counties funded by the Children's Bureau under the Adoption 
Opportunities program. Now completing its second year of a planned 
three years of operation, this program utilizes a variety of methods 
including concurrent permanency planning by child protection and 
adoption staff, mediation services, recruitment and training of special 
fost-adopt homes, and use of post-adoption counseling therapists to 
address the issues of the birth and fost-adopt families. By building on 
the curriculum development, cross training, outreach to the legal 
community, and recruitment and support of fost-adopt homes already 
underway, the demonstration project would facilitate acceleration of 
the project schedule to Essex county, which contributes the largest 
number of children to the State's foster care caseload.
    New Jersey hypothesizes that allocating case management staff and 
other resources to the dedicated units would reduce foster care costs 
and lengths of stay and lead to more adoptive placements and/or more 
stable relative placements than would occur in the comparison groups 
over the five years of the project. Assignment to comparison groups 
will be randomized,

[[Page 37392]]

and the evaluation would produce process and outcome data, as well as 
cost/benefit information.
    The State requests waivers to permit the use of title IV-E funds 
for purposes not ordinarily eligible for federal funding, and for 
children or families who are not IV-E eligible.
    Counties not involved in the project would serve as the control 
group, and after the first year the project would be extended to other 
randomly selected counties.
    Contact Person: Michele K. Guhl, Deputy Commissioner, Division of 
Youth and Family Services, P.O. Box 717, Trenton, New Jersey 08625-
0717, Phone: (609) 292-6920, Fax: (609) 984-0507.

State: New Mexico

    Description: The New Mexico project would provide title IV-E 
funding as a direct pass through of federal funds to identified Tribes, 
simulating direct federal funding of Tribes under title IV-E in order 
to test this concept. In addition, the State is proposing the 
establishment of a subsidized guardianship program for Tribal children, 
which the State says would allow permanency while respecting Tribal 
customs. The demonstration project would test both simulated direct 
funding and flexible use by Tribes of IV-E funds.
    Currently, title IV-E funding is extended by the State to five 
Indian Tribes through a Joint Powers Agreement (JPA). The JPA spells 
out procedures to be followed in cases of child abuse and neglect, 
including how investigations are to be conducted, how and when 
jurisdiction is to be transferred, and how and when parties are to be 
notified. It also provides that the State would pay Tribes to cover the 
foster care maintenance and adoption assistance for IV-E eligible 
children in Tribal custody.
    The State proposes a comparison design for the evaluation. The five 
Tribes currently operating under JPA's would serve as the comparison 
sites. Five additional Tribes would be selected as the pilot sites. The 
selection of the pilot sites would be purposive, based on the Tribes' 
willingness to participate and their capacity in terms of the human and 
material resources and infrastructure currently in place to manage the 
IV-E Program. A five year project is proposed.
    Title IV-E waivers are requested to allow for the provision of non-
recurring expenses and ongoing assistance payments for guardians 
assuming responsibility in those instances where Tribal Courts are 
reluctant to terminate parental rights, to provide Federal Financial 
Participation for individuals and purposes that are not IV-E eligible.
    Contact Person: Maryellen Strawniak, Acting Director, Protective 
Services Division, PO Drawer 5160, Santa Fe, New Mexico 87502, Phone: 
(505) 827-8400, Fax: (505) 827-8480.

State: Oklahoma

    Description: Oklahoma proposes a project to provide assisted 
guardianship to the permanency continuum for long-term foster care 
children for whom adoption or reunification is not an option. The goal 
of the project is twofold: to determine if quality, permanency outcomes 
can be achieved for these children; and to assess the impact of 
providing services, e.g., post-placement services, on achieving these 
outcomes.
    The State anticipates that assisted guardianships would provide a 
permanency plan option for children in long-term foster care; alleviate 
the financial barriers for persons who desire to obtain guardianship, 
thereby enhancing the prospects of permanency for these children; and 
provide stability for children. In addition, the demonstration would 
provide an opportunity to test the impact of different levels of 
services and supports to children and families served by the project in 
achieving quality permanency outcomes for children. The State also 
anticipates that the project would reduce the workload for child 
welfare staff, allowing them time to do expedited permanency planning 
for the remaining children.
    The State currently has approximately 1,100 children statewide in 
long-term foster care; 15 percent of these children are Native 
American. Some of the Native American children are in the legal custody 
of the Department while others are in tribal custody. The State 
estimates that 550 of these children would be potentially eligible for 
this project, with approximately 200 children and families actually 
served under the project. The State proposes three different levels or 
categories of services and supports to children and families who 
participate in the demonstration, with each category having 50-100 
children and families assigned to it. The State would test the 
permanency outcomes for children in relation to the level or category 
of services provided to each family. The State proposes a statewide, 
five-year demonstration project.
    Oklahoma proposes to randomly assign children to one of the 
following: a control group, which would receive the current service 
mix; Target Group I, which would receive all identified waiver services 
and a full range of on-going post placement services; or Target Group 
II which would receive all initial services included in the waiver, but 
limited on-going post placement services. To assess the project, 
Oklahoma proposes to measure outcomes, processes and cost-benefits.
    The State requests waivers of title IV-E provisions regarding use 
of title IV-E funds to pay: a monthly subsidy for children in 
guardianship arrangements; the cost of legal fees required to obtain 
guardianship; and the costs of providing a range of services and 
supports to families and children in guardianship situations (similar 
to the services received by adoptive families and children).
    Contact Person: Mike Moore, Division of Children and Family 
Services, P.O. Box 25352, Oklahoma City, OK 73125, Phone: (405) 522-
4487, Fax: (405) 521-4373.

State: Texas

    Description: Texas proposes a Child Welfare Demonstration project 
with three components over five years. The components affect kinship 
care, adoption and Texas' Permanency Achieved through Coordinated 
Efforts (PACE) project.
    First, Texas proposes to implement a kinship care program as part 
of Protective and Regulatory Services (PRS) and requests a waiver of 
title IV-E to utilize otherwise restricted funds for foster care 
assistance, in conjunction with title IV-B funds, to provide upfront 
financial assistance and services for kinship care placements. The 
state hypothesizes that if families are provided financial assistance 
for the costs of integrating the child into the home during the first 
year of care and then supplementing caretaker expenses thereafter to 
support the child's care, are trained, and take part in support groups, 
more placements would be made and would succeed, to the benefit of the 
families and children served by PRS. The length of time in foster care 
would decline, freeing up funds devoted both to staff and foster care 
maintenance.
    Texas proposes to implement the kinship initiative in El Paso and 
in Corpus Christi, Laredo and the Lower Rio Grande Valley. To evaluate 
this component, the State would implement a matched-group comparison of 
three groups: (1) Those that received the Integration Package, which 
would consist of startup money, and the Training and Services Package; 
(2) those that received only the Training and Services Package; and (3) 
those that receive neither package. The state

[[Page 37393]]

would measure: implementation through qualitative means; process 
outcomes through the provision and use of incentives, provision and use 
of services and parenting skills and knowledge; and outcome through 
case flow, duration of time in care, patterns of disruption and rate of 
dissolution and/or re-entry. A cost-benefit analysis would asses 
whether the costs of the demonstration project are justified by the 
benefit produced.
    The second proposed component of Texas' demonstration project is to 
use title IV-E funds for the assessment of prospective adoptive 
children and families and to allow for joint training with Child 
Placing Agencies (CPA) of CPA professionals providing adoption and 
permanency services. The state's hypotheses are that a more 
comprehensive assessment would reduce the disruption and dissolution 
rate of PRS adoptions, decrease the average length of time that 
children spend in foster care prior to adoptive placement, increase 
satisfaction among children and families, decrease the number of 
placements before placement in an adoptive home, and increase the 
number of children leaving foster care for placements with adoptive 
families. These improvements would speed permanency and reduce 
expenditure of IV-E funds.
    Texas proposes to implement this demonstration project in Harris 
County, Houston and the counties surrounding Houston. To evaluate this 
project, the state proposes to compare one region which would receive 
an Enhanced Training condition and an Enhanced Assessment condition, to 
other regions and to statewide historical data. The evaluation would 
include implementation measures of a qualitative nature; process 
measures including pool of potential families, assessment, quality of 
placements and extension of training; and outcome measures such as case 
flow, duration of time in care, patterns of disruption and rate of 
dissolution and/or reentry into the Child Protective Services System. A 
cost benefit analysis would assess whether the costs of the project are 
justified by the benefits produced.
    The third component of the proposal is to utilize title IV-E funds 
flexibly as part of Phase II of the State's PACE project. The state-
funded Phase I of PACE is designed to contract for a network of private 
providers to provide a continuum of services designed to improve 
substitute care service and enhance PRC permanence initiatives. The 
State requests a waiver of title IV-E for Phase II of PACE, to pay for 
foster care services and child and family services on a per-child case 
rate or capitated rate, to the network of providers established in 
Phase I. PRS would test the impact of the case rate on an expansion of 
service delivery model that is developed in Phase I.
    The state hypothesizes that the new service delivery system would 
result in improved child functioning, increased stability of 
placements, shortened duration of care, reduced rate of return to 
foster care, and maintenance of least restrictive placements. The state 
hypothesizes that for Phase II, capitated rates would result in: cost 
neutrality, the ability to provide a case rate for daily care and 
supervision reimbursement, increased incentives for providers to 
provide treatment and services to improve children's level of care 
(LOC), increased ability to provide wraparound services for children 
for quicker movement to permanency or for placement in the least 
restrictive environment and increased incentive to provide preventive 
services to lessen the need for high cost treatment/residential 
services. Children would be placed by random assignment into an equal 
number of PRS and Primary Contractor foster homes.
    The state evaluation proposal would compare the outcomes of four 
subgroups of LOC children in PACE Phase II, to three types of 
comparison groups: randomly assigned control groups, statistically 
matched cross-sectional comparison groups, and historical comparison-
sectional comparison. The state would measure: implementation through 
qualitative means; process through continuity of care, expanded 
services and satisfaction with services; and outcome through change in 
LOC, change in level of care domains, change in rated individual goals, 
duration of time, patterns of disruption, rate of reentry and rate of 
maltreatment recurrence. A cost-benefit analysis would assess whether 
the costs of the demonstration project are justified by the benefits 
produced.
    Contact Persons: Texas Department of Protective and Regulatory 
Services, 701 W. 51st Street, P.O. Box 149030, Austin, TX 78714-9030, 
Karen Eells (Kinship Care & Adoption), Judy Rouse (PACE), Phone: (512) 
438-5712, Fax: (512) 438-3394.

State: Washington

    Description: Washington State proposes to adopt a managed care 
approach for services such as mental health and family preservation to 
children who are IV-E eligible and children who are not. Under the 
demonstration project, the State would make monthly payments for the 
care of children with complex needs who have been screened into the 
project. These funds would be pooled with other resources to contract 
with local service providers for oversight of treatment plan 
development, implementation, screening and training. The State 
postulates that such coordination between the State and various local 
service providers might result in a better use of resources, while also 
providing individualized and comprehensive wraparound services. The 
State hopes that such an approach would enable it to tailor services to 
meet the real needs of families and children particularly those 
children with special needs and problems.
    Washington State would begin the project in Spokane county and 
phase in other counties until a maximum of ten counties were included 
in the demonstration project. The State would randomly assign children 
to either the control or demonstration. The State proposes to evaluate 
the project through random assignment comparison, pre/post comparison 
and a cost-benefit analysis.
    The State requests waivers of certain sections of title IV-E and 
related regulations to allow expenditures on behalf of children and 
families not normally eligible under title IV-E, and to allow 
expenditures for services not normally permitted under title IV-E. The 
State is also considering the possibility that it might request a 
waiver of title XIX pertaining to Behavioral Rehabilitation Services.
    Contact Person: Tammi Erickson, Office Chief, Office of Federal 
Funding and Victims' Assistance, State of Washington Department of 
Social and Health Services, P.O. Box 45710, Olympia, WA 98504-5710, 
Phone: (360) 902-7936, Fax (360) 902-7903.

State: West Virginia

    Description: West Virginia proposes a school based services 
project, the Cabell County Adopt-A-Middle-School project. The project 
would provide a variety of services for children in middle schools 
(grades 6, 7, and 8) and their families, whether or not they would 
otherwise qualify for the title IV-E. The purpose of the service 
provision is to create a seamless social support system that 
strengthens the ability of children and families to handle stress 
affecting their lives by: facilitating school-based support for child 
victims of abuse and neglect who can be kept in the home and community; 
providing early identification of youth with delinquent tendencies in 
order to link the child and family with services prior to the 
initiation of court action; utilizing home

[[Page 37394]]

and community-based services whenever possible; ensuring EPSDT 
screening and appropriate treatment for children in foster care; and 
assisting the Department in maintaining linkages with schools for out-
of-home placement, facilitate return to school for the child and 
family, and assist students who are new to the school district due to 
foster or adoptive placements.
    To accomplish these services, WV proposes a two-phase 
demonstration. Phase one would pair community social services agencies 
with middle schools in Cabell County as resources for information, 
assessments, and referrals. Phase two proposes the hiring of full-time 
prevention coordinators for each school, beginning with two schools and 
phasing in additional schools as resources permit. Coordinators would 
be school-based during the school year, would serve as initial case 
managers and advocates for the child/family, provide direct services, 
and provide follow-up with families over the summer months.
    The State's hypothesis is that middle school-based prevention and 
early intervention programs would result in a reduction of the number 
of children in foster care, the average expense and intensity of foster 
care, and the average number of days children are in foster care. This 
project would be limited to Cabell County, in southwestern WV, which 
includes six middle schools. The project is proposed to begin in 
September 1998 and would run through August 2003.
    The State requests waivers of title IV-E to permit reimbursement 
for amounts expended for children and families and for purposes that 
are not normally eligible under IV-E.
    For evaluation purposes, the state proposes to identify a control-
group county. Outcome measures would include the number of children 
entering foster care, the number of placements in community-based or 
family settings, and the number of days the children are in foster 
care. Process evaluation components include frequency and types of 
intervention activities. An outside evaluator would conduct the 
evaluation.
    Contact Person: Joan E. Ohl, Secretary, Department of Health and 
Human Resources, Bureau of Children & Families/Office of Social 
Services, Charleston, West Virginia 25305, Phone: (304) 558-0684, Fax: 
(304) 558-1130.

    Dated: June 25, 1998.
James A. Harrell,
Deputy Commissioner, Administration on Children, Youth and Families.
[FR Doc. 98-18437 Filed 7-9-98; 8:45 am]
BILLING CODE 4184-01-M
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